Friday, 21 August 2009

NHS Serious Staffing Problems

As mentioned many times by Cassandra, UK NHS is one of the biggest employers in the world. With that size comes a lot of bureaucracy which allows lots of hiding places for poor performance and bad people. This poor performance on the people front is evidenced by NHS UK's staff sickness rate (150% higher than the industrial sector), and an inability to develop its own people. Because it can't train enough of its own staff UK NHS is now the biggest importer of health care labour in the world. Thus the NHS imports more nurses than any other country, and more doctors and surgeons than any other country. In effect denuding poor countries of much needed skilled helath care staff. What a terrible accolade that is!
So, the United Kingdom, a country that considers itself to be in the leading ranks of civilised nations, with seats on the UN Security Council, and G8 along with many other other international bodies, preaches to others about probity and the rule of law, while it is using financial muscle to take away doctors and nurses from poorer countries like Nigeria, and India, leaving their populations with fewer health care staff for themselves. That is after these same countries have spent millions of dollars training them. In effect the UK NHS (and by implication the people of the UK) is subsidised by Nigeria and India and other poor nations.
However for the UK there is a down side of this arrangement in that the NHS because it does not vet people properly regularly hires under qualified people. Some if not caught early enough go on to cause real harm to patients. But that's not all. Due to the NHS's bad management of staff it is ironic that as a result the UK also holds the world record for the number of terrorists in any western organisation, ie the NHS. Please don't take this item as the mad ramblings of a right wing extremist. Read the news of who did the bombing across the UK and check out the bombers' employers. What a mess.

BT In Trouble - Still

This week's Economist magazine has a special article that picks at the flaws of BT in the usual Economist insightful manner. But it seems to miss what we consider to be some key points.
Firstly when BT devolved itself of its mobile business it tacitly accepted that it is a renter of fixed land line services, and not a communications company. Thus condemning the business in the long term to low value, low growth land line markets that are being surrounded and bypassed by mobile and radio telephony.
Secondly it started Global Services to move up the 'value chain' and become a services supplier to major corporations. If it had done so based on Telco services perhaps it would have made it. Sadly BT thought it could manage client data centres, desk tops, and write applications too. As history has shown, and we have previously blogged, it got this badly wrong.
Thirdy, it completely failed to create a management team, not just close to the board, but down through the organisation capable of facing a more commercial world.
This is why we continue to believe that BT must get back to basics and become a communications business again. One that can deal with the modern fast paced commercial less regulated world. We forecast that over the coming months Global Services will 'discover' more problems with major contracts, like NPfIT, and will be taking more write downs.
Unless radical steps are taken by Ian Livingston and his leadership team, on the current track it looks like BT will become rather like British Airways (a much Knighted, much Lorded flying pension fund) in that BT will become a copper cable pension fund with a value based on metal exchange prices, with more Knights and Lords of its own. Good for them. Bad for shareholders and staff.

Footnote: Speaking of capable IT Services management. Many Global Services managers now work for other IT services companies. They were probably hired when BT GS ruled the roost and their personal value was high. Now their new employers must be wondering if they have brought in the right sort of people given that they contributed to GS's downfall. But there again, perhaps the new employers like; Logica and HP/EDS, have not woken up to this one yet?

Thursday, 20 August 2009

CSC Results - again

Have any of the analysts who track IT Services companies worked out how much of the increase in CSC's reported increase in EPS is due to the stock buy back that cost the company billions of dollars?
I'll bet they haven't.
Put the EPS story to one side and you have a company going nowhere for three years that is bolstered by US Federal contracts, and of course the overblown, over priced, under delivered, yet very profitable for some, but not the English tax payer, UK NHS IT programme. I would venture to guess that without NHS IT CSC Europe would have to close down (so would iSoft), and without Obama's deep pockets CSC US would be in the toilet.
Come on analysts run the numbers and speak up.

Thursday, 13 August 2009

NHS Patient early deaths continue. Will no one stop them?

Read this little episode as an example of how well NHS is doing at meeting its targets and ignoring patients while doing so. Apparently the service worked wonderfully, according to the service provider, but the patient had the nerve to die.
I wonder what McBrown will put in his twitter about this........?

Thanks to Mark Steyn for this extract from his blog.,com_frontpage/Itemid,33/

Here's one of those anecdotal horror stories from Scotland's National Health Service that we are enjoined by American "reformers" to pay no heed to. From the Daily Record:

A mum suffering chest pains died in front of her young son hours after being sent home from hospital and told to take painkillers.
Debra Beavers, 39, phoned NHS 24 twice in two days before getting a hospital appointment. But a doctor gave what her family described as a cursory examination lasting 11 minutes, before advising her to buy over-the-counter medicine Ibuprofen...
Seven hours later, the mum-of-two collapsed and died from a heart attack in front of her 13-year-old boy.

It's one of those stories that has all the conventions of the genre: The perfunctory medical examination; the angry relatives; the government innovation intended to pass off an obstructive bureaucracy as a streamlined high-tech fast-track ("NHS 24" is some sort of 1-800 helpline). Indeed, in the end, it's all about the bureaucracy: The 1-800 guys don't think you're worth letting past the health-care rope line. So you call again, and ask again, and they say okay, we'll find you someone, but he can only spare eleven minutes of his busy time. And, while you're being carried out by the handles, the bureaucracy insists that all went swimmingly:

NHS 24 executive nurse director Eunice Muir said: "We can confirm Ms Beavers contacted NHS 24 and that her onward referral was managed safely and appropriately."

Phew! Thank goodness for that. In the Wall Street Journal, our old friend Theodore Dalrymple writes:

In the last few years, I have had the opportunity to compare the human and veterinary health services of Great Britain, and on the whole it is better to be a dog.
As a British dog, you get to choose (through an intermediary, I admit) your veterinarian. If you don’t like him, you can pick up your leash and go elsewhere, that very day if necessary. Any vet will see you straight away, there is no delay in such investigations as you may need, and treatment is immediate. There are no waiting lists for dogs, no operations postponed because something more important has come up, no appalling stories of dogs being made to wait for years because other dogs—or hamsters—come first.
The conditions in which you receive your treatment are much more pleasant than British humans have to endure. For one thing, there is no bureaucracy to be negotiated with the skill of a white-water canoeist; above all, the atmosphere is different. There is no tension, no feeling that one more patient will bring the whole system to the point of collapse, and all the staff go off with nervous breakdowns. In the waiting rooms, a perfect calm reigns; the patients’ relatives are not on the verge of hysteria, and do not suspect that the system is cheating their loved one, for economic reasons, of the treatment which he needs.

That's because, in their respective health systems, Fido is a valued client, and poor Debra Beavers wasn't.

Cassandra comment.
This and other episodes of failures by NHS bring to mind the old image of the British 'jobsworth' mentality that was so prevalent when Trades Unions ruled the land. I am now beginning to think it is a British cultural phenomina that has always existed. It allows people to say 'Well I did my job as per instructions', or 'It's more than me-jobs-worf to use discretion' while watching failures occur all around. In many cases the NHS failures lead to deaths. I guess as an Anglo-Saxon, quasi Germanic race this attitude is very similar to that of the WWII German soldier who just following orders when committing an attrocity.
What a legacy from McLabour!

Saturday, 8 August 2009

Guardian newspaper's PR for Labour's NHS IT Failure

The Guardian newspaper group continues to show it is the unpaid PR arm of the Labour government by starting to criticise those who have reported that NPfIT is a sham, a failure, and a waste of money. See Guardian article by Vic Lane on 4th August 2009.
This blog along with many others has surfaced sufficient information to support the above criticsms and there is nothing in the article; by a learned professor, for health infomatics, to support her case. What a shame she has not done sufficent analysis to support her thesis. She should read Tony Collins at Computer Weekly amongst others and not, like a tame Guardian reader, quote Barack Obama's so far failed health initiative if she wants real evidence.